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Evidence Based Practice. Assignment. 2

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11 views

Evidence Based Practice. Assignment. 2

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vexor57723
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NAME: AREEBA TAHIR

ROLL# M-18250
COURSE TITLE: EVIDENCE BASED PRACTICE
ASSIGNMENT: PROPOSAL/METHODOLOGY FOR RCT STUDY.
Topic: Impact of Alzheimer's Disease on Balance and Fall Risk in Elderly Populations
Research Question:
How do changes in cognitive function over time influence balance performance in elderly
individuals diagnosed with Alzheimer's disease?
PICO Question:
In elderly individuals, how does Alzheimer's disease affect balance compared to those without
Alzheimer's disease in terms of impaired balance and risk of falls?
 P: Elderly individuals diagnosed with Alzheimer's disease
 I: Impact of Alzheimer's disease on balance
 C: Elderly individuals without Alzheimer's disease
 O: Impaired balance and increased risk of falls
Objective:
Investigate how Alzheimer's disease impacts balance and mobility in elderly individuals.
Assess the extent to which Alzheimer's disease increases the risk of falls and balance
impairments compared to elderly individuals without the disease.
Identify potential underlying mechanisms (e.g., cognitive decline, motor function impairments)
contributing to balance disturbances in patients with Alzheimer's disease.
Hypothesis:
Elderly individuals diagnosed with Alzheimer's disease have significantly greater balance
impairments and a higher risk of falls compared to elderly individuals without Alzheimer's
disease.
Type of study: Case Control
Involves comparing two groups, elderly individuals with Alzheimer's disease (cases) and those
without (controls).
Sample size:
Assumptions:
 Effect size (Cohen's d): 0.5 (medium effect)
 Significance level (α): 0.05
 Power (1 - β): 0.80
 Ratio of cases to controls: 1:1
Using these assumptions in a sample size calculator for a case-control study, the estimated
sample size may be around:
Cases: Approximately 64 participants with Alzheimer’s disease.
Controls: Approximately 64 cognitively healthy elderly participants.
Total Sample Size:
Total: 128 participants (64 cases + 64 controls)
Variable used:
Dependent Variable (DV): Balance Impairment
Tool used:
Berg Balance Scale (BBS): A widely used tool to assess balance in older adults through a series
of functional tasks such as standing, sitting, and turning.
Timed Up and Go (TUG) Test: A simple and reliable test to assess balance and mobility.
Tool validity and Reliability:
The Berg Balance Scale (BBS) is a highly reliable and valid tool for assessing balance and
predicting fall risk, particularly in elderly populations and those with neurological impairments
such as Alzheimer’s disease. Its strong content validity ensures that it covers a comprehensive
range of balance tasks relevant to daily life, while its construct and criterion validity are
supported by correlations with other established measures of balance and mobility.
Tool interpretation and scoring:
Scoring the Berg Balance Scale:
Scale: Each of the 14 items is scored on a scale from 0 to 4, where:
 0: Unable to perform the task
 1: Requires assistance to perform the task
 2: Performs the task but with difficulty
 3: Performs the task with minimal difficulty
 4: Performs the task independently and safely
Total Score: The maximum total score for the BBS is 56 (4 points for each of the 14 items).
A higher score indicates better balance and functional performance.
Interpretation of Scores:
41-56: Low fall risk
Individuals in this range are generally considered to have good balance and are at low risk for
falls. They can perform most balance tasks independently and safely.
21-40: Moderate fall risk
Individuals in this range may have some difficulty with balance tasks and are at an increased risk
of falls. They may require assistance or supervision during certain activities.
0-20: High fall risk
Individuals scoring in this range are considered to have significant balance impairments. They
may require assistance for many daily activities and are at a high risk of falls.
Treatment Protocol:
 Assessment phase
 Setting goals
 Physical therapy intervention
 Cognitive training
 Occupational therapy interventions
 Progress monitoring
 Duration and frequency
Data collection:
This structured data collection procedure ensures that the study is conducted ethically, reliably,
and effectively, leading to meaningful insights into the impact of Alzheimer’s disease on balance
in the elderly population. The involvement of trained personnel, the use of standardized
assessments, and careful management of data are crucial for achieving valid and reliable results.
Randomization in Groups:
Group-1: Experimental Group: Individuals with Alzheimer’s disease who will receive the
intervention (e.g., balance training).
Group 2: Control Group: Individuals with Alzheimer’s disease who will not receive the
intervention (or receive standard care).
Data analysis procedure:
 Data Preparation
 Data Cleaning
Ensure that the data collected on balance (e.g., Berg Balance Scale scores), fall history, and
Alzheimer’s diagnosis are complete and accurate.
 Group randomization:
Alzheimer’s Group: Elderly individuals diagnosed with Alzheimer’s disease.
Control Group: Elderly individuals without Alzheimer’s disease.
 Descriptive Statistics
Baseline Characteristics
Balance Scores and Fall History
Conclusion:
The data analysis procedure for this study focuses on comparing balance performance (using the
Berg Balance Scale) and fall risk between elderly individuals with Alzheimer’s disease and those
without.
Alzheimer's disease significantly affects balance and increases the risk of falls in elderly
individuals compared to those without the disease. The findings suggest that Alzheimer's patients
experience greater postural instability, likely due to the cognitive and motor impairments
associated with the disease. These balance impairments make individuals with Alzheimer's more
prone to falls, contributing to a higher risk of injury. Addressing balance issues through targeted
interventions and preventive measures may help reduce fall-related risks and improve the quality
of life for elderly individuals living with Alzheimer's disease.

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